My father has developed a stage 4 pressure ulcer in the ischial area. It was surgically debrided at the hospital, and the resulting cavity is about the size of a golf ball. The doctor is packing it with betadine soaked ribbon gauze. How do I convince him that this treatment is outmoded and harmful? Our WORN has told us that not only is it not effective in reducing bacterial load, it also destroys healthy granulating tissue.
I've done a google search and a search using IE, but cannot find any hard-core studies that support this. Nor does any of the wound care material I've been given by my company quote any scientific studies. Indeed the one study I found on the net with any supporting data indicated the opposite. (It read like it had been written by the manufacturers of Povodine!)
The nursing home (having caused this by failing to reposition my dad frequently enough in his wheelchair) are now bending over backwards to get it healed (multivitamins, high protein diet, special bed, turning q 2 h., etc). The one thing I'm not happy with is the doctor's insistence on betadine. He says it will help kill off the bacteria, and debride the wound.
Dec 14, '03
Hi--I went to a terrific workshop with this wound care nurse from Oregon (I'm in Texas). She has a website (try this
). What she taught is exactly what you are talking about, and, if memory serves, she has the citations and studies to back it up.
She is also pretty available personally--I telephoned them because I couldn't find my certificate....they are lovely, helpful, wonderful people who know their stuff.
Dec 22, '03
Jay Jay - the JBI has a clincal practice review on Pressure area managment and it does mention types of fluids to clean the area and states that NO antiseptics are recommended.
Jay Jay - I also tracked down this link
Last edit by gwenith on Dec 22, '03